We herein report a case of acute edema/cutaneous distention syndrome (AECDS) triggered by refeeding in a patient with anorexia nervosa. Patients with anorexia nervosa should be carefully monitored because nutritional therapy may induce AECDS.
A 48-year-old woman presented to our hospital in June 2007 with a sudden onset of bilateral swelling of her legs. She had been previously diagnosed with anorexia nervosa. A peripheral vascular examination excluded the possibility of venous thrombosis. Two days later, she noticed painful eruptions on her swollen lower legs. Physical examination revealed a markedly thin woman with a weight of 24 kg (−54% of ideal body mass index). Erythema, linear erosions, and greyish bullae were present on her edematous lower legs (Figure 1A). Orificial and anogenital areas were not involved.